Maina Teresia, Willetts Annie, Ngari Moses, Osman Abdullahi
Department of Public Health, School of Health and Human Sciences, Pwani University, P.O Box 196-80108, Kilifi, Kenya.
Institute of Global Health and Development, Queen Margaret University, Edinburgh, UK.
Trop Med Health. 2021 Dec 28;49(1):100. doi: 10.1186/s41182-021-00391-3.
Tuberculosis (TB) remains a top global health problem and its transmission rate among contacts is higher when they are cohabiting with a person who is sputum smear-positive. Our study aimed to describe the prevalence of TB among student contacts in the university and determine factors associated with TB transmission.
We performed a cross-sectional study with an active contact case finding approach among students receiving treatment at Kilifi County Hospital from January 2016 to December 2017. The study was conducted in a public university in Kilifi County, a rural area within the resource-limited context of Kenya. The study population included students attending the university and identified as sharing accommodation or off-campus hostels, or a close social contact to an index case. The index case was defined as a fellow university student diagnosed with TB at the Kilifi County Hospital during the study period. Contacts were traced and tested for TB using GeneXpert.
Among the 57 eligible index students identified, 51 (89%) agreed to participate. A total of 156 student contacts were recruited, screened and provided a sputum sample. The prevalence of TB (GeneXpert test positive/clinical diagnosis) among all contacts was 8.3% (95% CI 4.5-14%). Among the 8.3% testing positive 3.2% (95% CI 1.0-7.3%) were positive for GeneXpert only. Sharing a bed with an index case was the only factor significantly associated with TB infection. No other demographic or clinical factor was associated with TB infection.
Our study identified a high level of TB transmission among university students who had contact with the index cases. The study justifies further research to explore the genetic sequence and magnitude of TB transmission among students in overcrowded university in resource limited contexts.
结核病仍然是全球首要的健康问题，当接触者与痰涂片阳性患者同居时，结核病在接触者中的传播率更高。我们的研究旨在描述大学学生接触者中结核病的患病率，并确定与结核病传播相关的因素。
我们采用主动接触者病例发现方法，对2016年1月至2017年12月在基利菲县医院接受治疗的学生进行了横断面研究。该研究在肯尼亚资源有限环境下的农村地区基利菲县的一所公立大学进行。研究人群包括在该大学就读、被确定为合住宿舍或校外宿舍的学生，或与索引病例有密切社会接触的学生。索引病例定义为在研究期间在基利菲县医院被诊断为结核病的大学同学。通过GeneXpert对接触者进行追踪和结核病检测。
在确定的57名符合条件的索引学生中，51名（89%）同意参与。共招募、筛查了156名学生接触者，并采集了痰样本。所有接触者中结核病（GeneXpert检测阳性/临床诊断）的患病率为8.3%（95%置信区间4.5 - 14%）。在检测呈阳性的8.3%中，仅GeneXpert呈阳性的占3.2%（95%置信区间1.0 - 7.3%）。与索引病例同床是与结核病感染显著相关的唯一因素。没有其他人口统计学或临床因素与结核病感染相关。
我们的研究发现，与索引病例有接触的大学生中结核病传播水平较高。该研究为进一步研究探索资源有限环境下拥挤大学中学生结核病传播的基因序列和程度提供了依据。
